Dermatologic Manifestations of Lymphogranuloma Venereum Treatment & Management

  • Author: Jose A Plaza, MD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Jan 12, 2012
 

Medical Care

The treatment of choice for lymphogranuloma venereum (LGV) is doxycycline (100 mg orally bid for 21 d). Although azithromycin is effective against other chlamydial strains and may prove to be effective against infection with LGV serovars, no controlled treatment trials support the use of azithromycin treatment for LGV. Incision and drainage may result in nonhealing fistula formation, which can be minimized by draining involved lymph nodes from above the inguinal ligament. Symptomatic treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) and local heat for pain relief may be useful adjuncts.

Immunocompromised persons, such as those with HIV infection, should receive the same treatment as immunocompetent persons; however, given the lack of data, patients with HIV infection and other immunocompromising conditions should be followed closely to assess resolution of symptoms.[12]

The New York State Department of Health clinical guideline summary, Lymphogranuloma Venereum (LGV), may be of interest.[13]

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Surgical Care

Surgery often is necessary for repair of late lymphogranuloma venereum (LGV) complications such as fistulas and strictures.

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Consultations

Surgical consultation for lymphadenopathy is generally not required unless extensive buboes require further exploration. For tertiary disease, appropriate surgical consultation is indicated.

A clinical guideline summary from the US Preventive Services Task Force, Behavioral counseling to prevent sexually transmitted infections: U.S. Preventive Services Task Force recommendation statement, may be helpful.[14]

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Contributor Information and Disclosures
Author

Jose A Plaza, MD  Director of Dermatopathology, Department of Pathology, Froedtert Hospital; Assistant Professor, Department of Pathology, Section of Dermatopathology, Medical College of Wisconsin

Jose A Plaza, MD is a member of the following medical societies: American Medical Association and American Society for Clinical Pathology

Disclosure: Nothing to disclose.

Coauthor(s)

Victor G Prieto, MD, PhD  Director of Dermatopathology, Professor, Departments of Pathology and Dermatology, University of Texas MD Anderson Cancer Center

Victor G Prieto, MD, PhD is a member of the following medical societies: American Association for the Advancement of Science, American Medical Association, American Society for Clinical Pathology, American Society of Dermatopathology, College of American Pathologists, European Society of Pathology, International Society of Dermatopathology, Society for Investigative Dermatology, and United States and Canadian Academy of Pathology

Disclosure: Nothing to disclose.

Specialty Editor Board

Terry L Barrett, MD  Clinical Professor of Dermatology and Pathology, University of Texas Southwestern School of Medicine; Director, ProPath Dermatopathology, Dallas, Texas

Terry L Barrett, MD is a member of the following medical societies: American Academy of Dermatology, American Dermatological Association, American Medical Association, American Society of Dermatopathology, College of American Pathologists, and United States and Canadian Academy of Pathology

Disclosure: Nothing to disclose.

Michael J Wells, MD  Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine

Michael J Wells, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, and Texas Medical Association

Disclosure: Nothing to disclose.

Lester F Libow, MD  Dermatopathologist, South Texas Dermatopathology Laboratory

Lester F Libow, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Texas Medical Association

Disclosure: Nothing to disclose.

Joel M Gelfand, MD, MSCE  Medical Director, Clinical Studies Unit, Assistant Professor, Department of Dermatology, Associate Scholar, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania

Joel M Gelfand, MD, MSCE is a member of the following medical societies: Society for Investigative Dermatology

Disclosure: AMGEN Consulting fee Consulting; AMGEN Grant/research funds Investigator; Genentech Grant/research funds investigator; Centocor Consulting fee Consulting; Abbott Grant/research funds investigator; Abbott Consulting fee Consulting; Novartis investigator; Pfizer Grant/research funds investigator; Celgene Consulting fee DMC Chair; NIAMS and NHLBI Grant/research funds investigator

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

The authors and editors of eMedicine gratefully acknowledge the contributions of previous authors, Jennifer D. Lorek, MD, Scott M. Acker, MD, Peter Langenstroer, MD, and Milton W. Datta, MD, to the development and writing of this article.

References

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